基于16S rRNA基因高通量测序分析慢性阻塞性肺疾病急性加重患者的诱导痰微生态多样性  

16S rRNA-base analysis of bacterial diversity in the induced sputum of patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：齐玉晶[1] 王哲[1] 孙雪皎[1,2] 宾雁飞[1,3] 李颖华 何志义[1] QI Yujing;WANG Zhe;SUN Xuejiao;BIN Yanfei;LI Yinghua;HE Zhiyi(Department of Pulmonary and Critical Care Medicine,The First Affiliated Hospital of GuangXi Medical University,Nanning,Guangxi 530021,P.R.China)

机构地区：[1]广西医科大学第一附属医院呼吸与危重症医学科,广西南宁530021 [2]柳州市人民医院呼吸与危重症医学科 [3]广西医科大学第二附属医院呼吸与危重症医学科

出　　处：《中国呼吸与危重监护杂志》2020年第4期359-365,共7页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S20180980);广西科技厅–广西科技重点研发计划项目(桂科AB17292044);中国宋庆龄基金会呼吸疾病临床研究公益基金2018年慢阻肺专项(2018MZFZY001)。

摘　　要：目的探讨慢性阻塞性肺疾病(简称慢阻肺)急性加重患者诱导痰微生态多样性的特点。方法使用16S r RNA高通量测序方法检测55例慢阻肺急性加重患者和45例稳定期慢阻肺患者的诱导痰标本。通过alpha多样性分析、beta多样性分析和Lef Se差异分析揭示慢阻肺急性加重患者诱导痰的微生态特点。结果慢阻肺急性加重组的诱导痰微生态多样性低于稳定期组。急性加重组诱导痰菌群丰度高于稳定期组。急性加重组的诱导痰菌群结构与稳定期相比发生改变,存在常见致病菌的构成比的增多。急性加重组的诱导痰微生态多样性与超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8),肿瘤坏死因子-α(TNF-α)、慢性阻塞性肺疾病全球创议(GOLD)分级水平呈负相关。结论与稳定期慢阻肺患者相比,慢阻肺急性加重患者的诱导痰微生态多样性下降,与血清炎症因子水平(hs-CRP、IL-8、TNF-α)和GOLD分级呈负相关。慢阻肺急性加重患者的菌群构成发生变化,常见病原体的构成比的增多,提示慢阻肺急性加重患者气道微生态存在明显失调。Objective To explore the characteristics of induced sputum microbiome in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Induced sputum samples from 55 patients with AECOPD and 45 patients with stable COPD were analyzed by sequencing of 16 S r RNA gene.Microbiota was measured by alpha diversity,beta diversity and LDA effect size analysis(Lef Se).Results The microbiome diversity of induced sputum in the AECOPD group was lower than that in the stable COPD group.The microbiome richness in the AECOPD group was higher than that in the stable COPD group.The microbiome structure changed in the AECOPD group compared with the stable COPD group.The proportion of some common pathogens got enriched.The levels of hypersensitive C reactive protein(hs-CRP),interleukin-8(IL-8),tumor necrosis factor alpha(TNF-α)and Global Initative for Chronic Obstructive Lung Disease(GOLD)grade were negatively related to the diversity of microbiome in the AECOPD group.Conclusions The microbiome diversity of induced sputum in AECOPD patients is decreased,and is negatively correlated with the levels of hs-CRP,IL-8,TNF-αand GOLD grade.There are differences in the microbiome structure between AECOPD and stable COPD patients.Some enrichment of common pathogens are found in the induced sputum of patients with AECOPD.These results suggest that there is a significant bacterial dysbiosis in patients with AECOPD.

关 键 词：慢性阻塞性肺疾病 急性加重 诱导痰 微生态 

分 类 号：R563.9[医药卫生—呼吸系统]